— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症個案說：「聯邦調查局正在透過電視監視我。」護理師哪種反應最恰當？
A client diagnosed with schizophrenia states, 'The FBI is watching me through the television.' Which response by the nurse is appropriate?
- AThat is not true, the FBI is not interested in you.這不是真的，聯邦調查局對你沒有興趣。
- BWhy would the FBI watch you?為什麼聯邦調查局要監視你呢？
- CI understand that you feel watched, but I do not see anyone.✓ 正解我理解你覺得被監視，但我沒看到任何人。
- DLet's go to your room where it is safer.我們去你的房間吧，那裡比較安全。
— Explanation · 中文詳解 —
針對妄想性思考，護理師應採取「呈現現實」（presenting reality）的策略，即表達我方觀察（沒看到人）並同時接納病人的感受（他覺得被監視）。A 選項直接辯論會導致對立；C 詢問原因會強化妄想系統；D 轉移話題並未處理當下的認知困擾。
The nurse should use a therapeutic communication technique known as presenting reality, which acknowledges the client's feelings without reinforcing the delusion. By stating personal observation (not seeing anyone) while validating the client's experience, the nurse builds trust and reduces anxiety. Arguing with or questioning the delusion can increase resistance and strengthen the false belief.
✦ 台美臨床差異
台美皆強調現實導向護理，在台灣，思覺失調症治療更強調家庭支持與藥物順從性。